Effects of high-dose i.v. steroid (pulse) therapy on acute serum sickness in rabbits.
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We investigated the effect of high doses (50 mg/kg/day) of i.v. methylprednisolone ("pulses") on a model of acute serum sickness in rabbits, using bovine serum albumen as antigen and endotoxin as an adjuvant. The pulses were given on 2 consecutive days at one of the following times during antigen elimination: Days 1 and 2, Days 5 and 6, and Days 8 and 9. Methylprednisolone did not alter antibody production, or the size of circulating immune complexes. Pulses given at any period inhibited the fibrinoid necrosis associated with arteritis, but did not otherwise lessen the histopathological changes. Pulses given on Days 1 and 2 or at the end of immune elimination on Days 8 and 9 increased proteinuria and haematuria, and tended to increase histopathological changes, whereas pulses given at the onset of immune elimination on Days 5 and 6 in contrast reduced haematuria, but had a variable effect on proteinuria and organ damage. In this model high-dose steroids produced no consistent amelioration of the disease, apart from reduced fibrinoid necrosis, and at some times there was a tendency for the disease to be exacerbated. (+info)
Rat serum sickness: possible role of inflammatory mediators allowing deposition of immune complexes in the glomerular basement membrane.
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Serum sickness was induced in rats by a modification of previously described methods avoiding i.v. administration of the antigen. All the animals developed a progressive disease characterized by an initial pattern of deposition of IC in the mesangium followed by the appearance of GBM deposits. This change in the deposition of IC was associated with the onset of massive proteinuria and a fall in the titre of precipitating antibodies. Simultaneously, specific desensitization of platelets for a rat PAF could be demonstrated and platelet aggregates were seen in the glomeruli. The presence of homocytotropic IgGa anti-ovalbumin antibodies in rat sera during the induction of the disease was demonstrated by 2 hr PCA. Accordingly, this antibody together with the antigen ovalbumin induced the release of histamine from peritoneal mast cells, suggesting that a similar mechanism might occur in vivo during the induction of the disease. Rat PAF and beta glucuronidase could be obtained from peritoneal macrophages under similar conditions to those required for the release of histamine. The data support a role for inflammatory mediators in the increase in vascular permeability needed for the deposition of IC in the GBM and provide evidence for a new role of macrophages and PMNs in glomerular pathology in contributing to an increase in permeability of GBM. (+info)
Induction of type 2 salivary cystatin in immunological and chemical kidney injury.
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We have previously reported that isoproterenol induces type 2 salivary cystatin in both submandibular glands and kidney tubule cells of rats but not in any other organs examined. In the present study, we investigated whether this salivary protein is induced in other conditions that show kidney tubule injury. Immunocytochemistry, using a monospecific antiserum to this cystatin, revealed specific staining within the proximal tubule epithelium of the cortex as well as in the inner and outer stripe of the medulla of immunologically and chemically injured rats. Cystatin could not be detected in kidneys from healthy rats by means of immunocytochemistry. Weak staining was found in 3/3 kidneys of rats treated with turpentine and in 5/5 animals treated with potassium dichromate. In rats treated with puromycin, cystatin could not be demonstrated in 5/5 animals having proteinuria of less than 100 mg/24 h; however, moderate staining was observed in 4/5 puromycin-treated rats having proteinuria greater than 100 mg/24 h. In Heymann nephritis, cystatin was present in 7/31 kidneys with proteinuria lasting 6 to 15 weeks and in none (0/7) with proteinuria of shorter duration. Strong staining was also observed in 10/10 kidneys from rats with moderate-to-severe chronic serum sickness. This study shows that elaboration of type 2 cystatin in rats is not limited to salivary glands and, with our previous study, suggests that induction of this cysteine inhibitor may represent a local response to generalized tissue injury in both submandibular and renal tissues. These findings further demonstrate that induction of cystatin in salivary glands is not unique to these glands and suggest that induction of this cysteine proteinase inhibitor may represent a local response to tissue injury caused by diverse mechanisms. (+info)
Circulating immune complexes after repeated halothane anaesthesia.
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A patient developed hepatitis after receiving three halothane anaesthetics in 22 days. Twenty-four hours after the onset of jaundice she developed an acute serum sickness syndrome with polyarthralgia, proteinuria, and transient impairment of renal function. Serum concentrations of complement components C1q, C4, and C3 were substantially reduced, and immune complexes capable of activating the complement system via the classical pathway were present in the serum and synovial fluid. A metabolite of halothane was associated with these complexes. Fourteen months after exposure to halothane her lymphocytes were stimulated in vitro by this metabolite. The conditions under which stimulation occurred were unusual--namely, a 7S fraction of the serum, presumably IgG, was necessary. Our results provide strong evidence that halothane may be immunogenic and that its immunogenicity is dependent on the non-covalent binding of one of its metabolites to plasma proteins. (+info)
Serum anti-rabbit and anti-horse IgG, IgA, and IgM in kidney transplant recipients.
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BACKGROUND: The therapeutic efficacy of horse antilymphocyte globulins (ALG) or of rabbit antithymocyte globulins (ATG), used for both the prevention and treatment of allograft rejection has been well documented. However, clinical use of these heterologous antibodies can result in the production of antibodies against horse or rabbit proteins and in the development of serum sickness via circulating immune complexes. METHODS: We studied the production of human IgG, and IgM anti-rabbit and anti-horse globulins, in 240 serum samples from 111 kidney transplant recipients, of whom 89 were treated with ALG or ATG (Merieux-France) as prophylaxis. RESULTS: Up to 8.9% of the patients had anti-ALG and/or -ATG antibodies before the first transplantation. This proportion increased significantly after. Preimmunization did not appear to be predictive of the occurrence of clinical serum sickness, yet sensitization increased, after transplantation, in up to 71% of the subjects who developed this disorder (P = 0.02). In patients receiving a second transplant, pretransplantation antibody levels were not modified by the immunosuppressive therapy applied. No relationship was found between early rejection and antiglobulin antibodies. CONCLUSIONS: Serum anti-rabbit and/or -horse antibodies were demonstrated in a significant proportion of kidney recipients, even before transplantation, possibly due to environmental exposure. A classical pattern of IgM increase was observed when the patients developed an immune response to ALG or ATG, and an IgA response after ALG. These results suggest that patients receiving ALG/ATG should be monitored for the production of anti-ALG/ATG immunoglobulins. (+info)
False increase in C-reactive protein attributable to heterophilic antibodies in two renal transplant patients treated with rabbit antilymphocyte globulin.
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Increased serum C-reactive protein (sCRP) is a sensitive marker of renal graft rejection. We describe the cases of two children with uncomplicated renal transplantation who had false-positive sCRP values on analyzers using rabbit anti-CRP but values within the reference range with anti-CRP from other animal species. Cross-reaction with heterophilic antibodies was suggested by clinical and biological signs of serum sickness and daily treatment with rabbit antilymphocyte globulin (ALG). The interference depended on the serum concentration of the cross-reactant and was removed by subtotal IgG adsorption to Protein A or Protein G or by immunoadsorption using rabbit ALG or total IgG in non-immune rabbit serum. Anti-rabbit IgG and IgM antibodies were detected in both patients. These are the first reported cases of cross-reaction with heterophilic antibodies in a turbidimetric CRP assay. (+info)